SB0024 94TH GENERAL ASSEMBLY

LRB094 03402 RAS 33404 b

94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
SB0024

Introduced 1/26/2005, by Sen. William R. Haine

SYNOPSIS AS INTRODUCED:

New Act

Creates the Home Health and Hospice Drug Dispensation and Administration Act. Allows home and community support services agencies and their employees who are registered nurses or advanced practice nurses to purchase, store, or transport certain drugs for the purpose of administering the drugs to home health or hospice patients of the agencies. Requires an agency that purchases, stores, or transports these drugs to establish policies and procedures concerning proper storage, transportation, temperature stability, removal from container on physician's order, administration of the drug, and the maintenance of written records. Provides that an agency or its authorized nursing employee may administer the drug only in the patient's residence under physician's orders. Sets forth procedures for agency handling of physician oral orders and pharmacy dispensation of the drugs. Provides that upon a home health agency's administration or dispensation of a specific drug to a patient, that agency shall be reimbursed the cost of that specific drug by the Department of Public Aid. Effective immediately.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning professional regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. Short title. This Act may be cited as the Home Health and Hospice Drug Dispensation and Administration Act.

Section 5. Legislative intent. The General Assembly intends to protect the home care services consumer by allowing qualified registered nurses in the home health and hospice professions to carry certain legend drugs in their nursing bags so they are readily available when a consumer may require their use.

Section 10. Definitions. In this Act:

"Nurse" means a registered nurse, advanced practice nurse, or registered professional nurse according to the Nursing and Advanced Practice Nursing Act.

"Home health" means a home health agency licensed by the Illinois Department of Public Health to provide this service or its employees who are nurses as defined above.

Section 15. Possession of sterile water or saline. A home and community support services agency or its employees who are registered nurses or advanced practice nurses may purchase, store, or transport the following for the purpose of administering to their home health or hospice patients under physician's orders:

(1) sterile water for injection and irrigation; and

(2) sterile saline for injection and irrigation.

Section 20. Possession of certain drugs.

(a) A home and community support services agency in compliance with this Section or its employees who are registered nurses or advanced practice nurses may purchase, store, or transport for the purpose of administering to their home health or hospice patients the following dangerous drugs:

(1) Sterile saline in a sealed portable container of a size determined by the dispensing pharmacist;

(2) Not more than 5 dosage units of any of the following items in an individually sealed, unused portable container:

(A) Heparin sodium lock flush in a concentration of 10 units per milliliter or 100 units per milliliter;

(B) Epinephrine HCI solution in a concentration of 1 to 1,000;

(3) Not more than 2 dosage units of Diphenhydramine (Benadryl) 50 milligrams intravenously for treating allergic reactions in an individually sealed, unused portable container, clearly labeled, and placed in a protective carrier. This is not to be used in a pediatric population.

Section 25. Proper procedures.

(a) A home and community support services agency or the agency's authorized employees may purchase, store, or transport dangerous drugs in a sealed portable container under this Section only if the agency has established policies and procedures to ensure that:

(1) The container is handled properly with respect to storage, transportation, and temperature stability;

(2) A drug is removed from the container only on a physician's written or oral order;

(3) The administration of any drug in the container is performed in accordance with a specific treatment protocol; and

(4) The agency maintains a written record of the dates and times the container is in the possession of a registered nurse or advanced practice nurse.

(b) A home and community support services agency or the agency's authorized employee who administers a drug listed in paragraph (a) of this Section may administer the drug only in the patient's residence under physician's orders in connection with the provision of emergency treatment or the adjustment of parenteral drug therapy.

(c) If a home and community support services agency or the agency's authorized employee administers a drug listed in paragraph (a) of this Section pursuant to a physician's oral order, the physician shall promptly send a signed copy of the order to the agency and the agency shall:

(1) Reduce the order to written form and send a copy of the form to the dispensing pharmacy by mail or facsimile transmission, not later than 24 hours after receipt of the order; and

(2) Send a copy of the order as signed by and received from the physician to the dispensing pharmacy, not later than 20 days after receipt of the order.

(d) A pharmacist that dispenses a sealed portable container under this Section shall ensure that the container:

(1) Is designed to allow access to the contents of the container only if a tamper-proof seal is broken.

(2) Bears a label that lists the drugs in the container and provides notice of the container's expiration date, which is the earlier of:

(A) the date that is 6 months after the date on which the container is dispensed; or

(B) the earliest expiration date of any drug in the container.

(3) Remains in the pharmacy or under the control of a pharmacist, registered nurse, or advanced practice nurse.

(e) If a home and community support services agency or the agency's authorized employee purchases, stores, or transports a sealed portable container under this Section, the agency shall deliver the container to the dispensing pharmacy for verification of drug quality, quantity, integrity, and expiration dates not later than the earlier of:

(1) The 7th day after the date of which the seal on the container is broken; or

(2) The date for which notice is provided on the container label.

(f) A pharmacy that dispenses a sealed portable container under this Section shall take reasonable precautionary measures to ensure that the home and community support services agency receiving the container complies with paragraph (f) of this Section. On receipt of a container under paragraph (f), the pharmacy shall perform an inventory of the drugs used from the container and shall restock and reseal the container before delivering the container to the agency for reuse.

Section 30. Reimbursement. Upon actual drug dispensation or administration under this Act, the home and community support services agency that dispensed or administered the drug to a patient shall be reimbursed by the Department of Public Aid for the cost of the drug used. Reimbursement shall cover only the agency's cost of the specific drug dispensed or administered.

Section 99. Effective date. This Act takes effect upon becoming law.